Stolen ID: Woman finds out she’s ‘in the hospital’ in LA County after filing Medicare claim for pickle injury.
Lynn Ianni didn’t learn she was apparently dying in a Los Angeles County hospice until her Medicare claim for beanball injuries was denied.
“We laughed at first because it was an obvious clerical error,” the Seattle-based psychiatrist said before a congressional committee Tuesday, where he was testifying about his months-long experience in 2024 with fraud in the hospice industry. “It wasn’t just frustrating, it was terrifying.”
Ianni appeared before the House Ways and Means Committee on Capitol Hill in a hearing that revealed details about the fraudulent claims and stolen physician credentials. He was a victim of California hospice scams. His situation, like many others, comes despite promises of reform from lawmakers five years ago, when rampant corruption in California came to light.
In late 2020, a Times investigation revealed that a group of elderly Americans were being targeted by unscrupulous providers who would bill Medicare for hospice services and equipment for patients who said they were terminally ill, but in fact were not.
Ianni was denied treatment for a pickleball-related shoulder injury. His health care provider, testifying, told him that his Medicare would not be able to pay for the treatment because he was enrolled in a hospital. He pointed out that even though a fraudster had stolen his Medicare ID number and enrolled him in the infirmary without his knowledge, he had to continue paying his premiums if he wanted help.
Ianni tracked down the hospice involved in the mall and the doctors who signed off on the fake care with their National Provider Identifier – it turned out that it was a Santa Monica surgeon whose identity was also stolen and “had absolutely no connection to the residence.”
“Despite revealing clear evidence of fraud, nothing has changed,” he told the committee.
Ianni said she reached out to the federal regulators who run Medicare, and they told her to file an appeal of the denied claims, a process that can take a year or more to resolve. He said eventually, with the help of an advocacy group, he got a new Medicare card and was able to continue physical therapy.
“It is proof of the failure of the system, which allows fraud to happen, preventing timely corrections and leaving vulnerable people without care, without answers and without protection,” Ianni told the authorities, saying that only his medical experience led him to overcome the problems.
Ianni’s testimony came at a time when the Trump administration has begun to focus on fraud in the state.
When the scope of the state’s fraud became apparent in 2020, one of California’s first steps was to freeze the issuance of new hospice licenses to give officials time to tighten oversight. State officials and industry representatives are crafting emergency rules that they say will address the gaps needed for hospice licenses to crack down on bad actors.
But years later, those laws have not been enforced. And the problems plaguing the industry continue despite state and federal enforcement efforts, experts say.
Since Dr. Mehmet Oz, director of the Centers for Medicare and Medicaid Services, or CMS, and a former TV personality, who visited LA in January, a new aggressive approach saw 450 hospices in the area suspended in the payment system as part of a team led by Vice President JD Vance.
While the Trump administration has singled out California as a fraud hot spot in the country, industry leaders told the committee Tuesday that the problems are nationwide.
“California is a clear current warning sign, but this is not just a California problem. It’s a federal Medicare-integrity problem and a state-federal oversight problem,” testified Sheila Clark, president and CEO of the California Hospice and Palliative Care Assn. “When fraudsters are allowed to enter the system, stay in the system, and shape the nature of the claims and cost reports used by CMS, beneficiaries and taxpayers across the country suffer.”
“They expose people who are vulnerable to exploitation, deny them appropriate care, undermine the credibility of Medicare, and, when left unchecked, distort the data and assumptions that federal policymakers rely on to oversee these benefits.”
Clark warned that fraudsters, despite the suspension of licenses in California, continued to thrive.
“The warning signs are common: clustering of providers at common addresses, rapid enrollment growth in saturated markets, repeated use of the same medical directors or certifying physicians, invalid or unverified contact information, Medicare exclusive payment for home health services in high Medicare Advantage markets, and significantly different clinical payment patterns,” she said.
He said the Centers for Medicare and Medicaid Services should “use its authorities early and be aggressive” to reduce fraud rather than reacting after it occurs.
